The Pap Smear Procedure

Learn what a pap smear procedure is, when it is ordered, what the results mean, and what other tests may be done.

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Why the Pap Smear Procedure is Ordered

A pap smear is a test that looks for cancerous or precancerous conditions in the cervix. Unlike many other cancer tests that are ordered in response to symptoms, a pap smear is performed as part of a woman's routine physical. Women beginning oral birth control for the first time may also be asked to take a pap smear test.

The recommendation for pap smears is that women should be tested every two years starting at age 21 or the onset of sexual activity, whichever occurs first. (Chang, 2009). Pap smears are important because cervical cancer can be prevented from occurring at all if precancerous conditions are caught early.

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How a Pap Smear is Done

A pap smear is part of a woman's pelvic exam. A device called a speculum is inserted into the vagina to widen the vaginal walls, allowing the doctor to see the cervix (Chang, 2009). A cotton swab or other instrument is then used to collect cells from the cervix. These cells are then examined in a lab.

Though most information available online about pap smears state that pap smears aren't painful, spreading the vagina can produce some mild pain for some women. Just because the vagina is designed to stretch doesn't mean it will do so easily.

Young women, virgins, women who have not had children, and those who have a smaller frame are most likely to experience pain. To reduce the likelihood of pain, patients should ask the doctor to explain exactly what will be done, and ask him or her to stop if something begins to hurt. Another option is to request a pediatric speculum, which is smaller than its adult counterpart.

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What Test Results Mean

Usually, pap smear results are expressed as either “normal” or “abnormal”, but sometimes, the terms “negative” and “positive” are used. “Negative” means “only normal cells were found”. Therefore, “negative” results mean the same thing as “normal.” The vast majority of women have “normal” or “negative” results for pap smear tests.

“Abnormal” results are more worrisome. Though an abnormal pap smear may be called “positive”, this does not necessarily mean the woman has cervical cancer. It can also mean that certain conditions are present that make cervical cancer more likely, such as the presence of human papillomavirus (MayoClinic, 2010). These conditions can be treated so that they never turn into cancer.

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What Other Tests May be Done

Normal or “negative” pap smear results require no further testing. If abnormal or positive results are found, any one of several tests can be done. If the doctor suspects the presence of human papillomavirus (HPV), he or she can order a new test on the same cells to check for the presence of the virus (MayoClinic, 2010).

Another test that may be done is a colposcopy. A colposcopy test is done by spreading the vaginal walls with a speculum (as with a pap smear). Then a magnifying device (which remains outside the vagina) is used to examine cervical tissue. If there is a strong possibility of cancer, the doctor may also order a biopsy of cervical tissue.